Safety Thought(s) of the Week… human error considerations
15 human error thoughts we need to consider during our next incident investigation and causal analysis:
Annual LOTO training does NOT satisfy the Annual Periodic Inspection requirements
There is an evil myth regarding LOTO training and Periodic Inspections. I recently had a lengthy discussion with a Labor Lawyer regarding the FACT that annual LOTO training does NOT satisfy the Annual Periodic Inspection requirements. An employer is NOT required to perform annual training on LOTO, but they are REQUIRED to conduct a periodic
TRUST and CREDIBILITY in Safety (Fukushima water release)
Maybe you’ve heard about the Fukushima water release plan. Or maybe you heard something about the drinking water debacle in Flint, MI. Or maybe you’re an emergency responder and are being bombarded about the Alcohol Film-Forming Foams (AFFF) you were exposed that had the “forever chemicals”. Or maybe you have a home with a basement
PRCS Fatality in Gypsum Baghouse (Engulfment)
At 3:35 p.m. on December 27, 2022, an employee was knocking gypsum dust off the interior walls of the end saw baghouse hopper. The baghouse was a large steel structure, 40 feet in height, with inward converging walls that led to two screw-augers that moved gypsum dust to the center of the hopper. The dust
HAZARDS of Hands-On PRCS Rescue Training
At 4:30 a.m. on January 11, 2023, an employee attended a Permit Confined Space Entry Rescue Training. The employee entered the manway and began to descend into a vessel. Approximately halfway into the entry, he realized he could not fit in and began to extract himself. He was distressed and lost consciousness. His coworkers attempted
Attention to detail needed with Respiratory Protection and Cl2 exposure
At 11:00 a.m. on May 23, 2019, an employee removed a regulator from a chlorine gas cylinder to perform yearly maintenance and repacking. When the employee attempted the close the shutoff valve, the valve malfunctioned and stopped turning while still slightly open without the employee’s knowledge. When the employee removed the regulator, chlorine gas escaped.
Line Break gone bad (pyrophoric materials)
Two workers were injured on an offshore platform while installing a skillet, the steel circular joining plate inside a section of piping. The incident occurred while the workers were on scaffolding and unbolting a 10-inch flange (Figure 1). After determining the skillet was the wrong size, the supervisor instructed a third worker to join the
Lack of Maintenance to Uninterruptible Power Supply Systems Leads to Failures (BSEE Alert)
Uninterruptible Power Supply (UPS) is a pretty common backup power supply in industrial settings where “power failure” can lead to the loss of control systems, emergencyshutdown systems, and emergency mitigation systems. But like ALL SAFEGUARDS we take credit for in our Hazard Analyzes, these UPS must be in our mechanical integrity program for testing/validation regularly
Dr. James Reason’s checklist for assessing Institutional Resilience
The assessment checklist below was developed by Dr. James Reason and presented at the 2000 Safety Conference. In Managing the Risks of Organizational Accidents, Dr. Reason argues that three (3) elements are vital for driving a company’s safety performance, all of them the purview of top managers: commitment, competence and cognizance The three Cs. But
Active Failures vs. Latent Organizational Failures (India’s Train Wreck)
“Despite efforts to improve safety, several hundred accidents happen every year, and most such crashes are blamed on human error or outdated signaling equipment.” Active Failures vs. Latent Organizational Failures These conflicts are always in the spotlight after tragedies. It took me many years working for some great leaders who always challenged me to look
How an organization goes about establishing its “culture of safety”
The establishment of a positive culture of safety within an organization is dependent on the following:
What does safety leadership LOOK and SOUND like from the C-Suite?
I came across these nine bullets from an SMS for a UK government agency. It may be the best-summarized listing of the behaviors and language we should see from the top executives within our organizations. I realize that one of the references talks about “prioritizing safety”; and although I am not a fan of that